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Joo, Jin-Deok,Chang, Jong-Hee,Kim, Jeong-Hoon,Hong, Yong-Kil,Kim, Young-Hoon,Kim, Chae-Yong The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.52 No.2
Objective : This study was performed to determine the safety and outcome of concurrent chemoradiotherapy (CCRT) and adjuvant chemotherapy with temozolomide for Korean patients with a newly diagnosed glioblastoma. Methods : Patients were recruited from four institutions between 2004 and 2007. The patients received fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks and daily temozolomide, followed by 6 cycles of adjuvant temozolomide. The primary endpoint was overall survival (OS) and the secondary endpoints were progression-free survival (PFS), response, and safety. Results : A total of 103 patients were enrolled in this study. Ninety-six patients (93%) completed the CCRT and 54 patients (52%) received 6 cycles of adjuvant temozolomide. The response rate was 73% (53/73) and the tumor control rate was 92% (67/73). Of the 96 patients who completed the CCRT, the median OS was 18.0 months and the 1- and 2-year OS rates were 74 and 38%, respectively. The median PFS was 10.0 months and the 1- and 2-year PFS rates were 33 and 16%, respectively. The only significant prognostic factor of survival was the extent of surgical resection (p<0.05). CCRT resulted in grade 3 or 4 hematologic toxic effects in 8% of patients. No opportunistic infections were noted. Conclusion : This study is the first prospective multi-institutional report of CCRT and adjuvant chemotherapy with temozolomide for patients with a newly diagnosed glioblastoma in Korea. The current protocol may prolong the survival of Korean patients with a glioblastoma and may be tolerable in terms of toxicity.
마취통증의학과 영역에서 Intra-cellular Signaling Pathway의 이용
주진덕 ( Jin Deok Joo ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3
At the level of individual cells, signaling is crucial in cell division, differentiation, metabolic control and death. Reception of the signals depends on receptor proteins that are usually at the cell surface, and these receptor proteins bind the signal molecule. The binding activates the receptor, which in turn activates one or more of the intra-cellular signaling pathways. These relay chains of molecules, mainly intra-cellular signaling proteins, process the signal inside the receiving cell and distribute it to the appropriate intra-cellular targets. Cell signaling pathways are involved in the pathophysiology of many diseases and also in the mechanisms of action of many drugs, including local and general anesthetics. Knowledge of the basic cell signaling mechanisms is essential for understanding many of the pathophysiologic and pharmacologic mechanisms. Therefore, if we focus on applying the new cellular and molecular biologic research, these efforts could identify the mechanism of diseases and help develop new drugs in the field of anesthesiology and pain medicine. (Korean J Anesthesiol 2009;57:277∼83)
주진덕(Jin-Deok Joo),한정호(Jung Ho Han),김영훈(Young-Hoon Kim),김택균(Tackeun Kim),김재용(Chae-Yong Kim),오창완(Change Wan Oh),유정희(Jung Hee Ryu),전영태(Young Tae Jeon) 대한두개저학회 2012 대한두개저학회지 Vol.7 No.2
Objective : We searched the incidence of postoperative nausea and vomiting(PONV) after microvascular decompression(MVD), which might potentially results in an increased risk of postoperative intracranial hemorrhage and neurologic dysfunction. METHODS : Between 2004 and 2010, a total of 109 patients were diagnosed as having a neurovascular cross compression, and were treated with lateral suboccipital craniotomy with MVD. The incidence of PONV and the use of rescue antiemetics were identified at 1, 24 and 48 hours after surgery. RESULTS : Seventy-one(65.1%) patients were female, and the mean age of the patients was 49±10 years(range, 20~69). The overall incidence of development of PONV within postoperative 48 hours was 69.7%. The incidences of PONV at 1, 24, and 48 hours after surgery were 31.1%, 56.8%, 44.0%, respectively. PONV was most prevalent at 24 hours after surgery, and then the incidence decreased over time. In the early postoperative period, female was significantly more susceptible to PONV than male, especially at 1 hour after surgery(p=0.035). CONCLUSION : The incidence of PONV was high enough to be actively managed, especially within 24 hours after MVD. PONV was more prevalent in female in the early postoperative period.
신경병증성 통증모델 쥐에서 리도케인의 ERK 1/2와 CREB 단백질 억제효과
주진덕 ( Jin Deok Joo ),인장혁 ( Jang Hyeok In ),정홍수 ( Hong Soo Jung ),김용신 ( Yong Shin Kim ),김대우 ( Dae Woo Kim ),최우영 ( Woo Young Choi ),신은영 ( Eun Young Shin ),전연수 ( Yeon Soo Jeon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3
Background: In addition to causing the loss of voluntary sensory and motor function, spinal cord injury (SCI) often creates a state of central neuropathic pain. Rats given SCI display increases in the activated form of transcription factors ERK 1/2, p38 MAPK, and CREB in the spinal cord, which correspond to allodynia in a model of neuropathic pain. The current study was designed to determine if lidocaine had an effect on the development of neuropathic pain in response to SCI. Methods: Male Sprague Dawley rats were anesthetized and then received a L5-L6 spinal nerve ligation (neuropathic rats). The levels of intracellular cell-signaling protein, ERK 1/2 and CREB were then assessed by western blot analysis of samples collected from a sham operated (control) group, a neuropathic pain and normal saline (NP+NS) group, and a neuropathic pain and 5% lidocaine (NP+Lido) group. Results: The increased levels of ERK 1/2 and CREB protein that were observed in the neuropathic pain model were reduced by continuous infusion of 5% lidocaine. Conclusions: The current results suggest that lidocaine therapy may be an effective method of preventing and treating central neuropathic pain following SCI, and that these effects may occur via the reduced expression of ERK 1/2 and CREB in the intracellular cell-signaling pathway. (Korean J Anesthesiol 2009; 56: 319~24)
백서 신경병증통증 모델에서 유도된 ERK 1/2와 CREB 신호 단백질에 대한 Ketamine의 억제효과
최진우 ( Jin Woo Choi ),인장혁 ( Jang Hyeok In ),김용신 ( Yong Shin Kim ),강유진 ( Yoo Jin Kang ),임용걸 ( Yong Gul Lim ),조수민 ( Su Min Cho ),신은영 ( Eun Young Shin ),주진덕 ( Jin Deok Joo ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.2
Background: In addition to causing the loss of voluntary sensory and motor function, spinal cord injury (SCI) often creates a state of central neuropathic pain. Rats given SCI display increases in the activated form of transcription factors ERK 1/2 MAPK and CREB in the spinal cord, which correspond to allodynia in a model of neuropathic pain. This study was conducted to determine if low dose ketamine had an effect on the activation of ERK 1/2 and CREB in the development of neuropathic pain. Methods: This study was conducted to evaluate ERK 1/2 and CREB protein in a sham operated (control) group, neuropathic pain and normal saline (NP+NS) group and neuropathic pain and ketamine (NP+Keta) group. To accomplish this, male Sprague-Dawley rats were anesthetized and then subjected to L5-L6 spinal nerve ligation (SNL, neuropathic rats). The total amounts of ERK 1/2 and CREB protein were then assessed by western blot analysis. In addition, changes in the amounts of ERK 1/2 and CREB mRNA were evaluated by RT-PCR. Results: There was a significant increase in the amount of ERK 1/2 and CREB in the NP+NS group when compared with the sham group. However, the amount of ERK 1/2 and CREB protein induced due to SNL were significantly reduced by continuous infusion with ketamine in the NP+Keta group. Conclusions: The results of this study revealed a positive linkage between NMDA receptors and the ERK-CREB signaling pathway. Therefore, NMDA receptors could be the target of future therapeutic approaches. Additionally, the results of the present study provide additional evidence that low dose ketamine effectively prevents and treats central neuropathic pain following SNL. (Korean J Anesthesiol 2009;57:210∼6)
실험연구 : 쥐에서 허혈 재관류 신장손상에 대한 반대편 신장의 허혈 선조정의 신장 보호효과
주진덕 ( Jin Deok Joo ),김대우 ( Dae Woo Kim ),강유진 ( Yoo Jin Kang ),김용신 ( Yong Shin Kim ),전연수 ( Yeon Soo Jeon ),인장혁 ( Jang Hyeok In ),최진우 ( Jin Woo Choi ),박연진 ( Yeon Jin Park ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2
Background: Acute renal failure (ARF) results from renal ischemic reperfusion (IR) injury and is a major contributor to the morbidity and mortality encountered during the perioperative period. It was previously demonstrated that ischemic preconditioning (IPC) of the heart, brain, and kidney offered protection against IR injury. Therefore, this study examined whether or not distant IPC can also be effective against IR injury in other organs. Methods: C57BL6 mice were classified into three groups, Sham group (n = 7), IR group (n = 7) and Cross IPC IR group (n = 7). The sham group was subjected only to a right renal nephrectomy (ligation of renal pedicle with silk). The IR group was subjected to 30 min of left renal ischemia after a right nephrectomy. The cross IPC IR group was subjected to right renal IPC (two cycles of 5 min of ischemia and reperfusion) followed 15 min later by a right nephrectomy and 30 min left renal ischemia. The left kidney was harvested 24 h after surgery and the histology and blood creatinine level was analyzed. The left kidneys were isolated 15 min after right nephrectomy (sham, n = 7) and right renal IPC (cross IPC, n = 7), respectively, and analyzed by western blotting. Results: The level of the intra-cellular signaling proteins, iNOS, Akt and ERK increased significantly as a result of the right renal IPC, and the renal functions were well preserved in the cross IPC IR group compared with the IR group. Conclusions: Cross renal IPC offers protection by elevating the iNOS, Akt and ERK levels due to the distant oxygen free radicals stream against the opposite renal IR injury in mice. (Korean J Anesthesiol 2007; 53: 229~33)
부분 간절제술로 급성간부전이 유도된 흰쥐에서 비장내 동종 간세포 이식
조주영,이준성,김홍수,김진오,이문성,황성규,김연수,심찬섭,조영덕,홍수진,천갑진,윤익진 대한소화기학회 1998 대한소화기학회지 Vol.31 No.5
Background/Aims: Various techniques of hepatocyte transplantation were actively studied as the alternatives to liver transplantation because of potential advantages including technical simplicity, low risk of operation and use of cells from a liver of single donor for multiple recipients, We investigated the effect of allogenic hepatocellular transplantation into spleen on the survival rate after 90% partial hepatectomy-induced acute hepatic failure in rats. Methods: Acute hepatic failure was induced by resection of all lobes except caudate lobe in Sprague-Dawley rats. Hepatocytes, isolated by collagenase perfusion of the liver via the portal vein, were transplanted into the spleen of rats after 90% partial hepatectomy (2.0×10^7 hepatocytes/rat). Results: There was significant difference in the survival rate between control group without treatment after 90% partial hepatectomy and transplanted group receiving intrasplenic allogenic hepatocellular transplantation after 90% partial hepatectomy. Engraftment and survival of transplanted hepatocytes were observed in spleen 2 days after transplantation. Conclusioas: We could observe significant improvernent of survival rate by intrasplenic hepatocellular transplantation in rats with 90% partial hepatectomy-induced acute liver failure. These results suggest that intrasplenic hepatocellular transplantation may be effective in the treatment of acute liver failure.